Skip to main content Accessibility help
×
Home

Shrink rethink: rebranding psychiatry

Published online by Cambridge University Press:  02 January 2018


Jim Crabb
Affiliation:
Forth Valley Royal Hospital, Larbert, NHS Forth Valley and University of Glasgow, Glasgow
Lee Barber
Affiliation:
Valenstein & Fatt, London
Neil Masson
Affiliation:
Stobhill Hospital, Glasgow and University of Glasgow, Glasgow, UK
Corresponding
E-mail address:

Summary

Negative public attitudes towards psychiatry hinder individuals coming for treatment and prevent us from attracting and retaining the very brightest and best doctors. As psychiatrists we are skilled in using science to change the thoughts and behaviours of individuals, however, we lack the skills to engage entire populations. Expertise in this field is the preserve of branding, advertising and marketing professionals. Techniques from these fields can be used to rebrand psychiatry at a variety of levels from national recruitment drives to individual clinical interactions between psychiatrists and their patients.


Type
Editorial
Copyright
Copyright © The Royal College of Psychiatrists 2017 

Rates of recruitment into psychiatry have been critically low in recent years, and in some parts of the UK mental health services are redesigning themselves for a future where they function with vastly fewer psychiatrists. In any other field of industry or human endeavour this situation would not be tolerated. If recruitment rates remained at such consistently abysmal levels in a large company, those employed to advertise and market the product would be sacked and a different approach adopted. If things persisted, those in charge on the board of the company would ultimately be fired. Why is the situation any different for psychiatry as a profession?

When we have attempted to re-market ourselves in recent years it has been psychiatrists who have designed strategies. The art and science of advertising, branding and marketing are not routinely covered in medical school and postgraduate curriculums. We have therefore no experience and expertise in these areas. Is it therefore any surprise that our attempts have floundered?

Almost every choice we make throughout the day, right down to the brand of laptop the reader might be viewing this article on, as well as the coffee they are sipping has been overtly or covertly influenced by professionals working in these fields. If we have not recognised this influence, then it merely serves to highlight the skill and effectiveness of those involved. Furthermore, as psychiatrists we take great pride in changing the thought patterns and behaviours of the patients we serve on an individual basis. Why would we not wish to learn and adopt techniques from fields that have expertise at doing this on a population level?

We have looked outside the worlds of psychiatry and academia for inspiration and to the worlds of advertising, branding and marketing. Some of the world's biggest companies from Coca-Cola to Apple have for decades been using a range of techniques to help them build brands that are loved and cherished by consumers. We need to apply the very same thinking to the challenges we face.

Reframing our objectives: knowing our audience

We know the undergraduate years are where negative attitudes and beliefs towards psychiatry take hold, 49% are favourable towards psychiatry as a career on entry, Reference Maidment, Livingstone, Katona, Whitaker and Katona1 whereas only 3% consider it on graduating. Reference Rajagopal, Redhill and Godfrey2 In marketing terms we therefore have a beautifully defined window of opportunity, and a captive audience to sell our discipline to. Therefore, getting an effective message across about psychiatry cannot happen early enough at medical school. The question is, even if we could reach new students, what positive ideas about psychiatry should we communicate? If we wish to counteract the powerfully corrosive bad mouthing that students hear about us from other disciplines, Reference Eagles, Wilson, Murdoch and Brown3 what should we say? This is where we need a strong brand.

Building a brand architecture

A brand is made up of many components, its attributes, audience, essence, etc (see Appendix). It is important to understand each of these elements and how they align in order to create a powerful brand that is meaningful for people and communicates confidently.

Developing a coherent brand that potential recruits can identify with might appear challenging. There are positive associations about psychiatry, however, even these can seem wildly disparate and contradictory, how can reassuringly scientific activities such as reading brain scans and intriguingly creative pursuits such as interpreting dreams possibly fall within the same specialty? However, we would argue that we should embrace these differences and incorporate them within our brand. We need to be clear that we are interested in the small number of doctors who can embrace the fields of science and the arts and also be confident enough to handle uncertainty and ambiguity. This of course does not appeal to the medical masses, however, it can also be a selling point. Niche brands such as Marmite have famously maximised their market share through making a virtue out of proudly advertising that they are not for everyone. Reference Mahdawi4

Bringing our brand to life

How we conduct ourselves in communicating our brand is a critically important starting point. We know that psychiatrists are victims of stigma, Reference Gaebel, Zäske, Zielasek, Cleveland, Samjeske and Stuart5 and having internalised this we may be part of the problem. Nothing sells like confidence. We need to inject confidence about what psychiatry is and does in everything we do.

We also know that we do not need to appeal to each and every medical undergraduate. We only need to increase our recruitment from 4 to 8% of medical graduates for all training places in the UK to be filled. Reference Davies6 This means that we can build a strategy around being selective. To date we have tended to try and sell ourselves as being ‘just as good’ as other medical specialties. This is a nonsensical way to market anything. (Did you choose your last holiday destination because it advertised itself as being just as good as some other place you had visited?) Instead we should be proudly elitist. Developing an air of exclusivity makes a product more desirable. Reference Mittone and Savadori7 Telling people they cannot have something makes them want it more. In recent years The Royal Marines have developed a highly successful recruitment drive based on this approach. Reference Jones8

We should be proud of and advertise the feet that we need the brightest and best doctors to enter psychiatry. The challenges involved in the job are vast (you know this), and a large number of doctors simply do not possess the mental agility to jump from biological to psychological to social paradigms within a single consultation. We should be telling students that we need the most special of them to come into our profession so that we can help develop them into a rare and exciting breed of doctor.

In recent years our approach has been to try and convince potential recruits and our colleagues from other disciplines that psychiatry is a ‘proper’ medical specialty and ‘just as scientific’ as others. As mentioned above, being ‘just as good’ would never be accepted as a marketing strategy in any other field. We should celebrate the phenomenal progress that has been made to date in understanding the mind, however, at the same time we should be clear that the frustrating limits of our knowledge is another thing that makes psychiatry uniquely attractive, that we are a discipline for pioneers and explorers.

Negative beliefs about the untreatability of psychiatric disorders can be challenged and turned into a selling point. Dare we communicate that neurology might be considered like understanding the electrical wiring to a light bulb in your house, whereas psychiatry in comparison is like building and flying a rocket to rescue a soul lost in the uncharted reaches of outer space? Such a ‘competitive’ approach between disciplines may seem initially unpalatable; however, it is worth remembering that Steve Jobs did not market Apple computers as being ‘just as scientific’ as Microsoft. Instead, this much smaller brand achieved a global identity and unprecedented success through a campaign of attracting those who wished to act and ‘think differently’. Reference Paris9

Such an approach also allows us to embrace our rich and controversial heritage and use this as a means of engagement rather than something to be nervously skirted around. If a student knows one thing about psychiatry it will be this, and it will be this they want to talk about (which reader has not been asked about One Flew Over the Cuckoo's Nest?). Can we not recognise that although R. D. Laing's mission was ultimately flawed, he did attempt to rescue those suffering and lost in psychic space using the best science available at the time; while still emphasising the lessons for today, namely that there is a need for a robust mission control to bring those doing ground-breaking work safely back to earth.

Ultimately though, the psychiatrist reading this piece is the media through which the brand is created, advertised and marketed. There will be no multi-million pound ad campaign. We need every person involved in the profession to live and breathe our brand and bring it to life every day and every time they come into contact with colleagues and students. Here are practical things you can do to promote a new brand of psychiatry.

  1. (a) Be unashamedly confident and proudly elitist when talking about psychiatry. Psychiatry is not, and should not be for every doctor. Most doctors cannot handle the challenges, complexities, contradictions and uncertainties of the discipline. As a practising psychiatrist you can, so walk tall. Carry this into each and every interaction with students and with your medical colleagues from other disciplines.

  2. (b) Have a ready explanation prepared for when someone asks you what a psychiatrist is, and does. If you are not comfortable with our suggested mantra (see below), develop your own based on the brand architecture model.

  3. (c) Celebrate the achievements of psychiatry. Know of three psychiatrists whose work you admire and who have been influential and a force for good on a global scale. Tell others about them. (If you are stuck, shame on you, go Wikipedia Carl Jung, Karl Friston, Kenneth Kendler and Eric Kandel.)

  4. (d) Think about and prepare answers for questions on our rich and controversial heritage: Bedlam, lobotomies, electroconvulsive therapy, LSD (lysergic acid diethylamide), anti-psychiatry, etc (you will be asked at the next dinner party you go to anyway). Be able to explain that the psychiatrist's role as a pioneer who searches out new ways to alleviate the suffering of those they serve was not, and still is not, without risk.

  5. (e) Know of at least three celebrities who have had a positive experience of mental healthcare that you can tell others about (the British Royal Family have recently given you a head start).

  6. (f) Think about and be prepared to tell others about cultural mega trends that link into psychiatry and that illustrate that we are the specialty of the moment, for the moment. Have at least two to hand (dementia, mindfulness etc.).

  7. (g) Survey your local core trainees to identify the most engaging and charismatic teachers in each hospital. Incentivise these teachers to have as much exposure to medical undergraduates as early in the preclinical curriculum as possible.

  8. (h) Communicate the key messages about ‘brand psychiatry’ to medical students as early as possible in the undergraduate years. These messages should be emphasised at the start and the end of every psychiatry block (to utilise the primacy and recency effect).

Fundamentally, we all are ‘brand psychiatry’ and this should be our mantra:

‘Psychiatrists are doctors who feel with their mind and think with their soul. They are just as comfortable with poetry as pathology. They see the person as whole. Psychiatrists understand the connection between the mind, the body and the soul. They are doctors who want to make a radical and transformational difference to the whole life of their patients. Psychiatrists are people who have the rare ability to treat the person, not the problem. Psychiatrists save lives.’

Appendix Brand architecture model

Component
of architecture model
What it is L'Oréal brand example Psychiatry brand model
Creative idea How the brand essence is expressed
creatively
Because you're worth it Changing minds
Brand idea The one most powerful idea that the
brand must come to represent
Science in the service of your beauty We heal mind, body and soul
Brand role The relevant role it has in the life of
the consumer
Making you more beautiful inside
and out
The only area of medicine that treats the
whole person – and not just the symptom
Personality How the brand communicates and
behaves on a human level
A beautiful scientist Challenging, intellectual and unashamedly
eccentric
Brand values How this is expressed as
motivational, connecting values
Stylish, classical, understated,
intelligent
Inquisitive, empathetic, socially aware,
pioneering
Brand attributes The emotional building blocks of the
brand
Innovation, science and beauty Holistic, curious, empathetic, compassionate,
quirky
Product attributes The functional elements of the
product we are selling
Innovative, safe hair colour and hair care
formulas and products
Unique and truly holistic specialty where
biopsychosocial paradigms are all integrated
Target consumer Who we are trying to influence with
our brand and its messages
Women 24–44 who want their hair
to make them look good and feel good
Medical students with deep empathy,
intellectual curiosity and creative flair

Footnotes

Declaration of Interest

None


References

1 Maidment, R, Livingstone, G, Katona, M, Whitaker, E, Katona, C. Carry on shrinking: career intentions and attitudes to psychiatry of prospective medical students. Psychiatr Bull 2003; 27: 30–2.Google Scholar
2 Rajagopal, S, Redhill, KS, Godfrey, E. Psychiatry as a career choice compared with other specialties: a survey of medical students. Psychiatr Bull 2004; 28: 444–6.Google Scholar
3 Eagles, JM, Wilson, S, Murdoch, JM, Brown, T. What impact do undergraduate experiences have upon recruitment into psychiatry? Psychiatr Bull 2007; 31: 70–2.Google Scholar
4 Mahdawi, A. Marmite: love or hate its PR, you have to admit it's strong stuff. The Guardian 2011; 30 November (https://www.theguardian.com/commentisfree/2011/nov/30/marmite-love-it-hate-it-pr).Google Scholar
5 Gaebel, H, Zäske, H, Zielasek, J, Cleveland, HR, Samjeske, K, Stuart, H, et al. Stigmatization of psychiatrists and general practitioners: results of an international survey. Eur Arch Psychiatry Clin Neurosci 2015; 265: 189–97.Google Scholar
6 Davies, T. Recruitment into psychiatry: quantitative myths and qualitative challenges. Br J Psychiatry 2013; 202: 163–5.Google Scholar
7 Mittone, L, Savadori, L. The scarcity bias. Appl Psychol 2009; 58: 453–68.Google Scholar
8 Jones, R. 13 of the most creative recruitment campaigns. Recruit Buzz 2014; 18 August (http://recruitmentbuzz.co.uk/13-of-the-most-creative-recruitment-campaigns/).Google Scholar
9 Paris, M. Apple – think differently. This is Not Advertising 2011; 5 September (https://thisisnotadvertising.wordpress.com/2011/09/05/apple-think-different/).Google Scholar
Submit a response

eLetters

Psychiatry - A Golden Pathway towards Personal Growth

23 May 2018
Larry Culliford, Author and retired psychiatrist, Royal College of Psychiatrists
Dear Jim, Lee and Neil, Congratulations on your article, which I have been thinking about since reading it some weeks ago. I fully agree with your aims (attracting doctors into psychiatry) and many of your arguments, but also have some reservations, which I would like to share. In this age of internet 'click-bait', it seems, when advertisements are designed 'to create an anxiety relieved by a purchase',... More
Conflict of interest: None declared

Rethinking rebranding

16 January 2018
Stephen Ginn, Consultant Psychiatrist, Camden and Islington Foundation NHS Trust
Recruiting sufficient psychiatrists in the UK apparently resists straightforward remedy. Crabb et al’s recent editorial Shrink rethink: rebranding psychiatry (1) is a welcome contribution on this subject. Innovative and provocative in turn, it urges that the psychiatric profession draw on expertise from the fields of advertising and public relations. We should engage with potential recruits by thinking... More
Conflict of interest: None declared

Shouldn’t we instead be preaching to the already converted?

27 December 2017
Ranjita Howard, Psychiatry Registrar CT3, Tees, Esk and Wear Valleys NHS Foundation Trust
I welcome the ideas in this article and agree that a lot more needs to be done to reform the negative image of psychiatry that is still widely held amongst the general public and within the medical profession itself. I find it particularly alarming that a lot of the damage, with respect to recruitment numbers at least, seems to be done during the medical school years given the considerable reduction... More
Conflict of interest: None Declared

Rebranding psychiatry: not only a matter of attracting talent but also keeping psychiatrists inspired.

20 November 2017
Joeri K. Tijdink, psychiatrist and researcher, VU Universiteit, department of Philosophy, Amsterdam, the Netherlands
Dear editor, With great interest we read the article of Crabb and colleagues entitled Shrink rethink: rebranding psychiatry recently published in your journal, convincingly making a case why it is important to rethink our ‘brand’ psychiatry and the importance of self-confidence for psychiatrists. Negative public attitudes towards psychiatry are omnipresent, also in the Netherlands and Belgium. In... More
Conflict of interest: All authors are member of the Dutch platform The Young Psychiatrist (De Jonge Psychiater, www.dejongepsychiater.nl) that is an independent platform with the aim to translate research into clinical practice and foster positive attitudes towards psychiatry in biomedicine and in society.

Altmetric attention score


Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 166
Total number of PDF views: 554 *
View data table for this chart

* Views captured on Cambridge Core between 02nd January 2018 - 1st December 2020. This data will be updated every 24 hours.

Access
Hostname: page-component-79f79cbf67-hdh2x Total loading time: 0.907 Render date: 2020-12-01T21:44:23.492Z Query parameters: { "hasAccess": "1", "openAccess": "0", "isLogged": "0", "lang": "en" } Feature Flags last update: Tue Dec 01 2020 21:05:49 GMT+0000 (Coordinated Universal Time) Feature Flags: { "metrics": true, "metricsAbstractViews": false, "peerReview": true, "crossMark": true, "comments": true, "relatedCommentaries": true, "subject": true, "clr": false, "languageSwitch": true }

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Shrink rethink: rebranding psychiatry
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Shrink rethink: rebranding psychiatry
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Shrink rethink: rebranding psychiatry
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *